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Pediatr Allergy Immunol. 2016 May;27 Suppl 23:1-250. doi: 10.1111/pai.12563.

EAACI Molecular Allergology User's Guide.

Author information

1
Paediatric Pneumology and Immunology, Charitè Medical University, Berlin, Germany.
2
Allergy & Asthma Center Westend, Outpatient Clinic Ackermann, Hanf, & Kleine-Tebbe, Berlin, Germany.
3
Department of Respiratory Diseases and Allergy, Institute of Clinical Medicine, Aarhus University and Aarhus University Hospital, Aarhus, Denmark.
4
Division of Immunopathology, Department of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria.
5
Department of Infection & Immunity, Luxembourg Institute of Health, Esch-sur-Alzette, Luxembourg.
6
Sanquin Research, Department of Immunopathology, Amsterdam, The Netherlands.
7
Landsteiner Laboratory, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.
8
Department of Allergy and Clinical Immunology, Faculty of Medicine, Transylvania University of Brasov, Brasov, Romania.
9
Ambulatorio di Allergologia, Clinica San Carlo, Paderno Dugnano, Italy.
10
Allergy Unit, Department of Dermatology, University Hospital Zürich, Zürich, Switzerland.
11
IMMA-School of Medicine, University CEU San Pablo, Madrid, Spain.
12
Department of Dermatology and Allergology, Technical University Munich, Munich, Germany.
13
Allergy Unit, Department of Internal Medicine, University Hospital Ospedali Riuniti di Ancona, Ancona, Italy.
14
Center of Allergy and Environment (ZAUM), Helmholtz Center Munich, Technical University of Munich, Munich, Germany.
15
Division of Experimental Allergology, Department of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology & Immunology, Medical University of Vienna, Vienna, Austria.
16
Department of Pathophysiology and Allergy Research, Medical University of Vienna, Vienna, Austria.
17
Paediatric Allergy, Department of Asthma, Allergy and Respiratory Science, King's College London, Guys' Hospital, London, UK.
18
Institute for Immunological Research, The University of Cartagena, Cartagena de Indias, Colombia.
19
Pediatric Allergy Unit, Department of Child and Adolescent, University Hospitals of Geneva, Geneva, Switzerland.
20
Swiss Institute of Allergy and Asthma Research, University of Zürich, Davos, Switzerland.
21
School of Biomedical Sciences, Institute of Biomedical Innovation, Queensland University of Technology, Brisbane, Qld, Australia.
22
Allergy Unit, 2nd Paediatric Clinic, National & Kapodistrian University, Athens, Greece.
23
Department of Allergy, Clinical Research Center for Allergology and Rheumatology, Sagamihara National Hospital, Kanagawa, Japan.
24
Allergy Department, Hospital Clinico San Carlos IdISSC, Madrid, Spain.
25
Division of Allergy and Immunology, Department of Molecular Biology, University of Salzburg, Salzburg, Austria.
26
Christine Kühne Center for Allergy Research and Education CK-CARE, Davos, Switzerland.
27
Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
28
Department of Dermatology, Paracelsus Private Medical University, Salzburg, Austria.
29
Department of Otorhinolaryngology, Academic Medical Center (AMC), Amsterdam, The Netherlands.
30
Department of Otorhinolaryngology, University Hospitals Leuven, Leuven, Belgium.
31
Department of Dermatology and Allergology, University Medical Center Giessen and Marburg, Justus Liebig University Giessen, Giessen, Germany.
32
Division of Clinical and Molecular Allergology, Research Centre Borstel, Airway Research Centre North (ARCN), Member of the German Centre for Lung Research (DZL), Borstel, Germany.
33
Interdisciplinary Allergy Division, Department of Pneumology, University of Lübeck, Lübeck, Germany.
34
Department of Clinical Immunology, 'ALL-MED' Medical Research Institute, Wrocław Medical University, Wrocław, Poland.
35
Molecular Allergy Research Laboratory, Centre for Biodiscovery and Molecular Development of Therapeutics, Australian Institute of Tropical Health and Medicine, James Cook University, Townsville City, Qld, Australia.
36
Departments of Immunology and Dermatology/Allergology, University Medical Center Utrecht, Utrecht, The Netherlands.
37
University Clinic of Respiratory and Allergic Diseases, Golnik, Slovenia.
38
King's College London, MRC & Asthma UK Centre in Allergic Mechanisms of Asthma, London, UK.
39
Division of Asthma, Allergy and Lung Biology, Guy's and St Thomas' NHS Foundation Trust, London, UK.
40
Skin and Allergy Hospital, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland.
41
National Service of Immuno-Allergology, Centre Hospitalier Luxembourg (CHL), Luxembourg, UK.
42
Department of Otorhinolaryngology, Medical University of Vienna, Vienna, Austria.
43
Pediatric Allergy and Immunology, Jaffe Food Allergy Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
44
Centre for Paediatrics and Child Health, Institute of Human Development, University of Manchester, Manchester, UK.
45
Unit of Allergology and Immunology, Niguarda Ca' Granda Hospital, Milan, Italy.
46
Service de Pneumologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.
47
Department of Microbiology & Immunology, University of Virginia School of Medicine, Charlottesville, VA, USA.
48
Allergy Clinic, Copenhagen University Hospital, Copenhagen, Denmark.
49
Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Ruhr-University Bochum (IPA), Bochum, Germany.
50
Allergy Division, Fundación Jimenez Díaz, Madrid, Spain.
51
Experimental Allergy Unit, IDI-IRCCS, Rome, Italy.
52
Department of Medicine Solna, Clinical Immunology and Allergy Unit, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden.
53
Departments of Experimental Immunology and of Otorhinolaryngology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
54
Department of Allergology, Paul-Ehrlich-Institut, Langen, Germany.
55
School of Medicine, University of Colorado, Denver, CO, USA.
56
Department of Medicine, National Jewish Health Service, Denver, CO, USA.
57
Sachs' Children's Hospital, Karolinska Institutet, Stockholm, Sweden.
58
The Referral Centre for Food Allergy Diagnosis and Treatment Veneto Region, Department of Mother and Child Health, University of Padua, Padua, Italy.
59
Department of Dermatology and Allergy Center, Odense Research Center for Anaphylaxis, University of Southern Denmark, Odense, Denmark.

Abstract

The availability of allergen molecules ('components') from several protein families has advanced our understanding of immunoglobulin E (IgE)-mediated responses and enabled 'component-resolved diagnosis' (CRD). The European Academy of Allergy and Clinical Immunology (EAACI) Molecular Allergology User's Guide (MAUG) provides comprehensive information on important allergens and describes the diagnostic options using CRD. Part A of the EAACI MAUG introduces allergen molecules, families, composition of extracts, databases, and diagnostic IgE, skin, and basophil tests. Singleplex and multiplex IgE assays with components improve both sensitivity for low-abundance allergens and analytical specificity; IgE to individual allergens can yield information on clinical risks and distinguish cross-reactivity from true primary sensitization. Part B discusses the clinical and molecular aspects of IgE-mediated allergies to foods (including nuts, seeds, legumes, fruits, vegetables, cereal grains, milk, egg, meat, fish, and shellfish), inhalants (pollen, mold spores, mites, and animal dander), and Hymenoptera venom. Diagnostic algorithms and short case histories provide useful information for the clinical workup of allergic individuals targeted for CRD. Part C covers protein families containing ubiquitous, highly cross-reactive panallergens from plant (lipid transfer proteins, polcalcins, PR-10, profilins) and animal sources (lipocalins, parvalbumins, serum albumins, tropomyosins) and explains their diagnostic and clinical utility. Part D lists 100 important allergen molecules. In conclusion, IgE-mediated reactions and allergic diseases, including allergic rhinoconjunctivitis, asthma, food reactions, and insect sting reactions, are discussed from a novel molecular perspective. The EAACI MAUG documents the rapid progression of molecular allergology from basic research to its integration into clinical practice, a quantum leap in the management of allergic patients.

KEYWORDS:

IgE; IgE cross-reactivity; allergy; allergy diagnosis; anaphylaxis; asthma; atopic dermatitis; component-resolved diagnosis; diagnosis; diagnostic algorithms; food allergy; guidelines; lipocalins; microarray; molecular allergology; non-specific lipid transfer proteins; panallergens; parvalbumins; pathogenesis-related protein family 10; polcalcins; precision medicine; profilins; serum albumins; tropomyosins

PMID:
27288833
DOI:
10.1111/pai.12563
[Indexed for MEDLINE]

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